SynthesisFrontiers in immunology2025
The prognostic and predictive value of AFP in immune checkpoint inhibitor-treated hepatocellular carcinoma: a systematic review and meta-analysis.
Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Predictive Value of On-Treatment Alpha-Fetoprotein Change for Lenvatinib Response in Patients with Hepatocellular Carcinoma: A Real-World Retrospective Study in Vietnam.Medicina (Kaunas, Lithuania) · 2026Article
- Efficacy of targeted hepatocellular carcinoma therapy using modified response evaluation criteria in solid tumors and alpha-fetoprotein: A single center retrospective exploratory study.Annals of hepato-biliary-pancreatic surgery · 2026Article
- From Theory to Practice: Which Biomarkers Are Ready for Predicting Response in Advanced HCC?Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Early C-reactive protein kinetics predict outcomes in unresectable hepatocellular carcinoma treated with immune checkpoint inhibitors: a multicenter, observational study comparing different C-reactive protein kinetic definitions.Frontiers in oncology · 2026Article
- Efficacy and safety of transarterial chemoembolization combined with sintilimab and bevacizumab in hepatocellular carcinoma.Frontiers in oncology · 2025Article
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Abstract
Introduction: Alpha-fetoprotein (AFP) is a universally recognized tumor marker in hepatocellular carcinoma (HCC). Its utility in assessing the response to immune checkpoint inhibitors (ICIs) remains controversial. This study aims to investigate the predictive value of AFP in ICIs-treated HCC patients. Method: A systematic search strategy was deployed across the PubMed, Embase, Cochrane Library and Web of Science databases. Hazard ratios (HR) or odds ratios (OR) and the corresponding 95% confidence intervals (CIs) were used to assess the pooled risk. Result: The study encompassed a total of 131 studies. Overall survival (OS) (HR = 1.60, 95%CI=1.47-1.74), progression-free survival (PFS) (HR = 1.35, 95%CI=1.27-1.42), and disease control rate (DCR) (OR = 0.50, 95%CI=0.29-0.84) were poorer in ICIs-treated patients with high AFP levels than those with low AFP levels. However, AFP levels were not associated with the objective response rate (ORR) (OR = 0.96, 95%CI=0.74-1.24). In addition, patients who achieved an AFP response had favorable OS (HR = 0.41, 95%CI=0.33-0.52), PFS (HR = 0.38, 95%CI=0.30-0.47), ORR (OR = 5.39, 95%CI=3.96-7.32) and DCR (OR = 5.48, 95%CI=3.71-8.11). Subgroup analyses revealed that AFP>400ng/ml and AFP decline greater than 20% were the most used and efficient cut-off values for high AFP level and AFP response, respectively. Conclusion: High AFP levels are associated with worse outcomes in ICIs-treated HCC. The assessment of AFP response demonstrated promising predictive value for both prognosis and therapeutic response to ICIs. Accurately defining early AFP response remains an area that requires further investigation. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD-42024606729.
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